Paediatric Robotic Transperitoneal Heminephroureterectomy in Complete Duplicated Systems: Early and Long-Term Outcomes

IF 2.3 3区医学 Q2 SURGERY

International Journal of Medical Robotics and Computer Assisted Surgery Pub Date : 2025-06-20 DOI:10.1002/rcs.70082

Donatella Di Fabrizio, Thomas P. Cundy, Azad S. Najmaldin

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引用次数: 0

Abstract

Background

We present outcomes for paediatric robotic heminephroureterectomy from a prospective single-surgeon series.

Methods

Children who underwent this operation between July 2007 and March 2017 were reviewed from a prospective database.

Results

There were 32 heminephroureterectomy (28 upper, 4 lower) for ureterocele (13), reflux (7), ectopic ureter (11), ureteric atresia (1). Co-morbidities (urological anomalies, recurrent infection, previous abdominal scarring) were common. Concomitant non-robotic procedures took place in 50%. Mean console time was 101 ± 30.2 min, hospital stay 29.5 ± 10.3 h. There were no conversions, intraoperative complications, and no remnant moiety function loss. Excision of diseased moiety calyces was complete in 30 (94%), incomplete in 2 (6%) who subsequently developed asymptomatic small marginal cysts. Eleven (34%) had total-ureterectomy, the remaining 21 (66%) were left with a ureteric stump. Postoperatively 3 (9%) females with residual stump (2 ureterocele, 1 bladder neck ectopia) and other urological anomalies underwent surgery (stump excision + reimplant refluxing remnant moiety ureter) for recurrent infection.

Conclusion

In children, heminephroureterectomy is well suited to a robotic approach with favourable outcomes in our experience.

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儿童机器人经腹膜肾输尿管切除术在完全重复系统：早期和长期的结果

背景：我们介绍了一项前瞻性单外科医生系列的儿童机器人半肾输尿管切除术的结果。方法从前瞻性数据库中回顾2007年7月至2017年3月期间接受该手术的儿童。结果输尿管囊肿（13例）、反流（7例）、输尿管异位（11例）、输尿管闭锁（1例）行输尿管半切32例（上输尿管28例，下输尿管4例）。合并症（泌尿系统异常，复发性感染，既往腹部瘢痕）是常见的。50%的患者进行了非机器人手术。平均控制台时间为101±30.2 min，住院时间为29.5±10.3 h。无转归，术中并发症，无残余部分功能丧失。30例（94%）完全切除病变部分肾盏，2例（6%）不完全切除，随后发展为无症状的小边缘囊肿。11例（34%）行全输尿管切除术，其余21例（66%）留下输尿管残端。术后3例（9%）女性残端（2例输尿管膨出，1例膀胱颈异位）及其他泌尿系统异常因复发感染而行手术（残端切除+再植入返流残段输尿管）。结论根据我们的经验，儿童半肾输尿管切除术非常适合机器人入路，效果良好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Medical Robotics and Computer Assisted Surgery 医学-外科

CiteScore

4.50

自引率

12.00%

发文量

131

审稿时长

6-12 weeks

期刊介绍： The International Journal of Medical Robotics and Computer Assisted Surgery provides a cross-disciplinary platform for presenting the latest developments in robotics and computer assisted technologies for medical applications. The journal publishes cutting-edge papers and expert reviews, complemented by commentaries, correspondence and conference highlights that stimulate discussion and exchange of ideas. Areas of interest include robotic surgery aids and systems, operative planning tools, medical imaging and visualisation, simulation and navigation, virtual reality, intuitive command and control systems, haptics and sensor technologies. In addition to research and surgical planning studies, the journal welcomes papers detailing clinical trials and applications of computer-assisted workflows and robotic systems in neurosurgery, urology, paediatric, orthopaedic, craniofacial, cardiovascular, thoraco-abdominal, musculoskeletal and visceral surgery. Articles providing critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies, commenting on ease of use, or addressing surgical education and training issues are also encouraged. The journal aims to foster a community that encompasses medical practitioners, researchers, and engineers and computer scientists developing robotic systems and computational tools in academic and commercial environments, with the intention of promoting and developing these exciting areas of medical technology.